Impact of consuming a Mediterranean-style diet during pregnancy on neurodevelopmental disabilities in offspring: results from the Boston Birth Cohort.
Impact of consuming a Mediterranean-style diet during pregnancy on neurodevelopmental disabilities in offspring: results from the Boston Birth Cohort.
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DOI：
10.1097/pn9.0000000000000047
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发表时间：
2023-09
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虽然孕妇食用地中海式饮食（MSD）预计会影响后代的神经发育，但目前的证据有限。这项前瞻性出生队列研究旨在探索母体MSD与后代神经发育障碍（NDD）的相关性，特别是超重或肥胖（OWO）和/或糖尿病（DM）母亲所生的儿童，因为他们有更高的氧化应激和免疫/代谢紊乱风险。我们分析了来自波士顿出生队列的母子二人组的数据。产妇饮食信息（通过食物频率问卷，食物频率问卷[FFQ]）和社会人口学信息通过产后24至72小时内的面对面访谈获得。母亲的临床信息和儿童诊断NDD包括自闭症，注意力缺陷/多动障碍（ADHD），和其他发育障碍（DD）的医疗记录中提取。使用FFQ计算地中海式饮食评分（MSDS）。使用多变量逻辑回归模型对相关协变量进行调整，评估母亲MSDS与NDD、自闭症、ADHD和其他DD的关联。这项研究包括3153对母亲-儿童，其中我们确定了1362（43.2%）NDD的诊断，包括123（3.9%）例自闭症，445（14.1%）ADHD，794（25.2%）其他DD。在总体样本中，母亲MSDS较高的女性（每标准差增加）不太可能有NDD后代（调整后的比值比[OR]：0.904，95%置信区间[CI]：0.817-1.000; P值：0.049）。使用MSDS五分位数1作为参考，在五分位数3-5的组合组中与NDD的可能性降低26%相关（校正OR：0.738，95%CI：0.572-0.951; P值：0.019）。当按母亲患有OWO/DM与未患有OWO/DM进行分层时，母亲患有OWO/DM的儿童的母亲MSDS与后代NDD之间的关联更大。在这个前瞻性出生队列中，较高的母体MSDS与后代NDD的可能性较低相关。此外，母亲的MSDS与后代NDD的这种关联在OWO/DM妇女所生的孩子中更大。需要更多的研究来复制这些发现，进一步分析NDD亚组并探索潜在的分子途径。
While consuming a Mediterranean-style diet (MSD) among pregnant women is expected to affect offspring neurodevelopment, the current evidence is limited. This prospective birth cohort study aimed to explore the association of maternal MSD with neurodevelopmental disabilities (NDD) in offspring, especially among children born to mothers with overweight or obesity (OWO) and/or diabetes mellitus (DM) since they have a higher risk for oxidative stress and immune/metabolic disturbances. We analyzed data from a subgroup of mother–child dyads enrolled in the Boston Birth Cohort. Maternal dietary information (via food frequency questionnaires, Food frequency questionnaires [FFQ]) and sociodemographic information were obtained via in-person interviews within 24 to 72 hours postpartum. Maternal clinical information and child diagnosis of NDD including autism, attention-deficit/hyperactivity disorder (ADHD), and other developmental disabilities (DD) were extracted from medical records. A Mediterranean-style diet score (MSDS) was calculated using the FFQ. The association of maternal MSDS with NDD, autism, ADHD, and other DD was evaluated using multivariable logistic regression models adjusted for pertinent covariates. This study included 3153 mother–child pairs, from which we identified diagnoses of 1362 (43.2%) NDD, including 123 (3.9%) case of autism, 445 (14.1%) ADHD, and 794 (25.2%) other DD. In the overall sample, women with a higher maternal MSDS (per standard deviation increase) were less likely to have offspring with NDD (adjusted odds ratio [OR]: 0.904, 95% confidence interval [CI]: 0.817–1.000; P value: 0.049). Using MSDS quintile 1 as the reference, being in the combined group of quintiles 3–5 was associated with a 26% lower likelihood of NDD (adjusted OR: 0.738, 95% CI: 0.572–0.951; P value: 0.019). When stratified by mothers with OWO/DM vs. without OWO/DM, the association between maternal MSDS and offspring NDD was greater in children born to mothers with OWO/DM. In this prospective birth cohort, a higher maternal MSDS was associated with a lower likelihood of NDD in the offspring. Furthermore, this association of maternal MSDS with offspring NDD was greater in children born to women with OWO/DM. More studies are needed to replicate the findings and further analyze NDD subgroups and explore underlying molecular pathways.